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Christopher L Jones, Derek G Kamper
Finger-thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger-thumb coupling during close-open pinching motions in stroke survivors with chronic hemiparesis...
2018: Frontiers in Neurology
Georges Al-Helou, Nardos Temesgen, Jonathan Gwizdala, Jalil Ahari
Our patient is a 69-year-old man who presented to the emergency department with left-sided hemiparesis that started 4 hours prior to presentation. Brain CT showed right basal ganglia and internal capsule haemorrhagic strokes. MRI revealed multiple brain lesions suspicious for metastases. Further workup revealed a 5 cm lung mass and a 1 cm pancreatic nodule. Biopsy of both pulmonary and pancreatic lesions was consistent with melanoma and was similar histologically. The patient underwent cyberknife stereotactic radiosurgery to the brain metastases followed by immunotherapy with pembrolizumab, and then by nivolumab and ipilimumab...
March 15, 2018: BMJ Case Reports
Veronica T Rowe, Marsha Neville
Task-oriented training is a contemporary intervention based on behavioral neuroscience and recent models of motor learning. It can logically be guided by the theory of occupational adaptation. This report presents the perceptions of four participants who underwent task-oriented training at home (TOTE Home) for upper extremity hemiparesis following a stroke. Guided by principles of motor learning and the theory of occupational adaptation, a directed content analysis was used with field notes recorded during the TOTE Home...
March 1, 2018: OTJR: Occupation, Participation and Health
David T Fernandes Cabral, Georgios A Zenonos, Maximiliano Nuñez, Pinar Celtikci, Carl Snyderman, Eric Wang, Paul A Gardner, Juan C Fernandez-Miranda
BACKGROUND: The endoscopic endonasal approach (EEA) has been proposed as a potential alternative for ventral brainstem lesions. The surgical anatomy, feasibility, and limitations of the EEA for intrinsic brainstem lesions are still poorly understood. OBJECTIVE: To describe the surgical planning, anatomy, and technique of an intrinsic pontine glioma operated via EEA. METHODS: Six-human brainstems were prepared for white matter microdissection...
March 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
Agnieszka Guzik, Mariusz Drużbicki, Grzegorz Przysada, Agnieszka Brzozowska-Magoń, Andżelina Wolan-Nieroda, Andrzej Kwolek
BACKGROUND: There are few reports in the literature investigating the relationship between observational gait scales used to assess individuals after a stroke and objective data acquired from 3-dimensional gait analysis (3DGA). RESEARCH QUESTION: The objective of this study was to compare the relationship between the specific items of the Wisconsin Gait Scale (WGS) and the matching 3-dimensional (3D) spatiotemporal and kinematic gait parameters in individuals after a stroke...
March 5, 2018: Gait & Posture
Gitendra Uswatte, Edward Taub, Mary H Bowman, Adriana Delgado, Camille Bryson, David M Morris, Staci Mckay, Joydip Barman, Victor W Mark
PURPOSE: To evaluate the efficacy of an expanded form of Constraint-Induced Movement Therapy (eCIMT) that renders CIMT, originally designed for treating mild-to-moderate upper-extremity hemiparesis, suitable for treating severe hemiparesis. METHODS: Twenty-one adults ≥1 year after stroke with severe upper-extremity hemiparesis (with little or no capacity to make movements with the more-affected hand) were randomly assigned to eCIMT (n = 10), a placebo-control procedure (n = 4), or usual care (n = 7)...
2018: Restorative Neurology and Neuroscience
Alessandra Rezende Martinelli, Daniel Boari Coelho, Luis Augusto Teixeira
Cerebral damage provoked by stroke may lead to deficits of quiet balance control and of the recovery of body equilibrium following an unanticipated postural perturbation. In this investigation we aimed to evaluate the effect of light touch (LT) of an earth-fixed surface on balance stability in individuals with post-stroke hemiparesis, taking performance of age-matched healthy participants as reference. Evaluations were made in conditions of full and no visual information. Analysis of quiet balance showed that LT induced higher balance stability, with reduced amplitude and velocity of postural sway...
March 7, 2018: Human Movement Science
R Espert, M Gadea, M Alino, J Oltra-Cucarella, C Perpina
INTRODUCTION: Moyamoya disease (MMD) is an occlusive cerebrovascular disease characterized by progressive stenosis or occlusion in the terminal portion of the bilateral internal carotid arteries, affecting both children and adults. AIM: To conduct a review and update on MMD from a clinical, neuroradiological, neuropsychological and genetic perspective. DEVELOPMENT: In this pathology, which occurs with ischemia or cerebral hemorrhage, an unusual compensatory vascular network (moyamoya vessels) develops at the base of the brain in the form of collateral channels...
March 1, 2018: Revista de Neurologia
Ralph Rahme, Tejaswi D Sudhakar, Marjan Alimi, Timothy G White, Rafael A Ortiz, David J Langer
BACKGROUND AND IMPORTANCE: Cerebral hyperperfusion syndrome (CHS) is a well-known complication of superficial temporal artery (STA) to middle cerebral artery (MCA) bypass for ischemic cerebrovascular disease. While this argues against "low flow" in the bypass construct, flow rates in the graft have not been previously quantified in the setting of CHS. CLINICAL PRESENTATION: A 58-yr-old man presented with recurrent left hemispheric ischemic strokes and fluctuating right hemiparesis and aphasia...
March 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Kohei Chida, Atsushi Sugawara, Takahiro Koji, Takaaki Beppu, Yoshiharu Mue, Tamotsu Sugai, Knuaki Ogasawara
A 79-year-old man presented with primary intramedullary malignant lymphoma with a presyrinx state in the cervical cord manifesting as left hemiparesis and hemidysesthesia. The magnetic resonance imaging (MRI) scan showed an intramedullary mass in the cervical spinal cord at the level of C1 and T2-weighted image prolongation from the medulla to the level of C5. According to the progression of hemiparesis, he underwent an emergency removal of the tumor under general anesthesia. The tumor was totally removed, and the peritumoral signal abnormality was not present in the postoperative MRI...
December 30, 2017: Curēus
Nakul Katyal, Christopher R Newey
Cerebrovascular autoregulation may be dysfunctional after acute intracerebral hemorrhage (ICH). This disruption in autoregulation can potentially result in secondary neurological damage that may present as an intracranial hemorrhage at locations distant from the primary site of hemorrhage. We discuss a case of 68-year-old female who presented with acute left hemiparesis from a spontaneous right frontal ICH. Magnetic resonance imaging (MRI) was negative for any other blooming artifact. Her weakness was improving, but after 72 hours from admission, she had an acute change in her mental status and was found to have a new left frontal ICH distant from the primary hemorrhage...
December 29, 2017: Curēus
Maud Pradines, Marjolaine Baude, Christina Marciniak, Gerard Francisco, Jean-Michel Gracies, Emilie Hutin, Nicolas Bayle
BACKGROUND: In current health systems, long duration stretching, performed daily, cannot be obtained through prescriptions of physical therapy. In addition, the short-term efficacy of the various stretching techniques is disputed and their long-term effects remain undocumented. OBJECTIVE: To evaluate changes in extensibility in six lower limb muscles and in ambulation speed following a ≥1-year self-stretch program, the Guided Self-rehabilitation Contract (GSC), in individuals with chronic spastic paresis...
March 2, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Sho Takeshita, Toshiyasu Ogata, Hidekazu Mera, Jun Tsugawa, Mikiko Aoki, Morishige Takeshita, Yoshio Tsuboi
A 65-year-old woman presented to our emergency room because of sudden onset of right hemiparesis with severe fatigue. Neurological examination revealed right hemiparesis with right facial numbness and an extensor planter response on the right side.Magnetic resonance imaging with diffusion-weighted imaging revealed multiple highintensity areas in both cerebral hemispheres and the right cerebellum. A diagnosis of acute stage of multiple brain infarctions caused by emboli was made. An abdominal computed tomography showed a pancreatic tumor with multiple liver metastases...
March 1, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Mohamed Almuqbil, Michael J Rivkin, Masanori Takeoka, Edward Yang, Lance H Rodan
GLUT1 deficiency syndrome (GLUT1DS) is a well described neurometabolic disorder that results from impaired glucose transport into the central nervous system. GLUT1DS classically presents with infantile-onset epilepsy, progressive microcephaly, developmental delay, ataxia, dystonia, and spasticity, but a minority of patients may manifest with paroxysmal non-epileptic phenomena including hemiparesis (Wang et al., 2002). We report for the first time cerebral perfusion changes during an acute episode of hemiparesis in a 9 year old child with GLUT1DS...
February 19, 2018: European Journal of Paediatric Neurology: EJPN
José Pedro Lavrador, Edson Oliveira, Joaquim Cruz Teixeira, José Pedro Lopes, José Pimentel, Manuel Herculano Carvalho
We report a 69-year-old patient with left paresthesia and hemiparesis. Magnetic resonance imaging revealed a right frontoparietal cystic tumor. A subtotal surgical resection was performed, and an Ommaya reservoir was left in place. The pathological diagnosis was supratentorial extraventricular anaplastic ependymoma. Radiation therapy was administered, and Ommaya reservoir drainages were performed. Four months after, her clinical status deteriorated after a reservoir drainage and image revealed an acute hemorrhage...
January 2018: Asian Journal of Neurosurgery
Oktay Gurcan, Ahmet Gurhan Gurcay, Atilla Kazanci, Tuncer Goker, Oguzhan Eylen, Omer Faruk Turkoglu
The Fahr syndrome (FS) is a rare degenerative neurological disorder (its prevalence is <0.5%). FS is distinguished by the presence of abnormal bilateral intracranial calcifications with a predilection for the basal ganglia, also presented by movement disorders such as parkinsonism, paresis, and speech disorders. Chronic subdural hematoma (CSH), which is typically the result of mild head trauma, is a regularly encountered condition in elderly. A 63-year-old man has referred to our clinic from another hospital with a history of mild head trauma approximately a month ago...
January 2018: Asian Journal of Neurosurgery
Tsuneo Nakajima, Toshihiro Sakai, Hitoshi Hara
We report a forty-six-year-old man with a past history of brain abscess managed by surgical drainage and recurrent ischemic strokes. After treatment of brain abscess, he had been on medication for symptomatic epilepsy, but had ceased medication by his judgment. He was taken to a hospital in an ambulance for an epileptic seizure. In the hospital he suffered from drug-induced renal dysfunction caused by the intravenous anti-epileptic drug, and right hemiparesis due to ischemic stroke occurred on the third hospitalization day...
February 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
Vikas Vazhayil, Nishanth Sadashiva, Nithish Nayak, A R Prabhuraj, Dhaval Shukla, Sampath Somanna
INTRODUCTION: Colloid cysts are uncommon lesions in the pediatric age group, which most commonly occur in the fourth through fifth decades. The authors hereby report a series of 36 patients with colloid cysts in the pediatric age group. MATERIAL AND METHOD: A retrospective chart review was conducted on all patients with colloid cyst who underwent surgery in our institute between November 2003 and December 2016 (13 years). Patients above the age of 18 were excluded from the study...
February 27, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Maxime Geiger, Céline Bonnyaud, Bernard Bussel, Nicolas Roche
OBJECTIVE: To assess temporal congruence (the difference in performance-time and time to imagine) between the sub-tasks of the Expanded Timed Up and Go (ETUG) and imagined ETUG (iETUG) tests in patients with hemiparesis following unilateral hemispheric stroke, and to compare the results with those for with healthy subjects. DESIGN: Case-controlled study. Subject/patients: Twenty patients with chronic stroke and 20 healthy subjects. METHODS: TUG, ETUG and iETUG test performance times were recorded for all participants...
February 28, 2018: Journal of Rehabilitation Medicine
Szu-Ju Chen, Li-Kai Tsai, Sung-Chun Tang, Jiann-Shing Jeng
PURPOSE: Isolated basilar artery dissection (BAD) is a rare cause of ischemic stroke. Since the clinical presentations and imaging findings could be non-specific and subtle, the diagnosis may be difficult. Here, we presented four cases of isolated BAD with acute ischemic stroke. CASE REPORT: Four patients (age, 22 to 57 years) experienced acute onset of hemiparesis and/or vertigo with half of them having initial headache. Acute infarct was noted at pons or thalamus...
September 15, 2017: Acta Neurologica Taiwanica
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